Date:
Company Name:
Your Reference No.: Jade Quote No.:
Name: 
Phone:             Fax:
E-Mail:

Shipment Details

Requested Pickup Date: Requested Time for Pickup:
Closing Time: Pickup Contact:
Pickup Location:

Port/Airport of Loading: Port/Airport of Discharge:
Shipping Terms (Ex Works, CIF, etc.-please indicate):
Payment Terms-Open Account, C.I.A., Letter of Credit (please indicate):

Commodity Description:

Gross Weight: Insurance Coverage (Y/N):

Dimension of Packages:
Hazardous Material (Y/N): If Yes: UN#: Class: Packing Group:
Quantity:
Flash Point (if needed):

Ocean Freight:
LCL (Y/N): FCL (Y/N): BB (for overweight/oversize) (Y/N):
If FCL, type and Amount of Containers:

Additional Comments: